If you’ve ever wondered about the mental health complexities facing the LBGTQ+ community, allow Casey Weitzman, MA, LMFT, President and Founder of Gender Wellness of Los Angeles, to tell the story of an 18-year-old young woman we’ll call Lucy. 

“She was assigned male at birth,” Weitzman explains, “and started suffering from gender dysphoria around the age of five. She didn’t want to come out to anyone, including her parents, until graduating from high school. She has been suffering in silence for 13 years.”

Lucy, like so many gay, lesbian, transgender and gender non-conforming youth, felt misunderstood and afraid to seek professional help for fear of not being believed, seen or heard. And this is exactly what needs to change, says Weitzman. 

“Parental support is a game changer,” she says. “Sometimes I have to tell parents, ‘I know this isn’t what you want to hear, but do you want a depressed and possibly suicidal child or do you want someone who is moving towards embracing and loving themselves?’ It can be quite shocking for parents to hear that the hopes and dreams they had for their child are now being challenged.”

What is beautiful, she quickly adds, is that after a short amount of time in therapy together, parents not only find understanding and acceptance, but they can become bigger advocates for their kids than the kids themselves.

We asked Weitzman what she wishes parents knew about the silent suffering LGBTQ+ and questioning youth experience as they transition through adolescence. Here’s what she told us: 

Consideration #1: Understand What’s at Stake

According to the National Alliance on Mental Health, lesbian, gay, and bisexual youth are twice as likely to experience persistent sadness or hopelessness, three times as likely to be sexually assaulted, and four-and-a-half times more likely to attempt suicide than their cisgender, straight peers.

The data is even more bleak for transgender and gender non-conforming youth, who are twice as likely to experience depressive symptoms, seriously consider suicide, or actually attempt suicide than cisgender lesbian, gay, bisexual, queer, and questioning youth.

What’s driving these mental health issues? Two key factors: a third of LGBTQ+ youth say their family is not accepting, and 40% say their community isn’t. 

But when immediate families support these youth, they are much happier than those whose families do not. 

“Non-LGBTQ+ kids worry about grades, sports, and all of the typical concerns that young people are faced with,” says Weitzman. “LGBTQ+ youth have those same stressors, plus they’re dealing with sexual orientation and/or gender identity, and they need to worry about being physically or sexually harassed, shamed, and rejected. It’s a lot to handle.”

Consideration #2: Social Media Giveth and Taketh Away

Social media is excellent at quickly raising awareness about social issues and motivating the digital troops to rally in support. It’s also a great platform on which haters can stand and spew their evil. 

“I’d say 9 out of 10 of the young people we treat at Gender Wellness of Los Angeles say they are out to their close friends, and 64% say they are out to their classmates,” Weitzman says. “Social media enables young people to easily find a community of like-minded individuals.”

“At the same time, it’s alarming that 92% of these youth say they hear negative messages about LGBTQ+ and the top sources are school, social media, and their peers.”

Because LGBTQ+ youth experience both the bright and dark sides of social media daily, parents need to be vigilant about monitoring their child’s online activities. 

“They often feel like their child should have independence,” says Weitzman, “but this is where they’re going to see a lot of the online trolling and sexual comments—all the parts that we fear the most can happen here.”

At the same time, many young people come out as LGBTQ+ in gaming settings because a lot of the characters are, or they can make their own avatars, says Weitzman. 

“For a lot of my trans and gender non-conforming youth, let’s say that they were affirmed male at birth, and they can now pick a female avatar for the first time in their lives,” she says. “It’s liberating for them, something they have never felt before.”

In other words, there’s great insight here that can lead to important conversations. 

Consideration #3: No, This Isn’t a Phase

“When meeting with my clients, they often share that they knew there was something different about them as early as four or five years old,” Weitzman says. 

“They will say they went into their mother’s or sister’s drawers or closet and tried on or borrowed a piece of clothing or even makeup, and the feeling of putting it on or seeing themselves in the mirror was affirming. Some have been struggling with this all of their lives.”

This is why, when they do come out to their parents, most do it over text or when their parents are away. It’s carefully planned because there’s a lot of fear, especially for transgender and gender non-conforming youth. They’ve been thinking about it for a long time, so how parents react is extremely important. 

“The guidance I offer parents is DON’T PANIC,” Weitzman says. “Be supportive no matter what, even if you don’t accept or believe it.” 

“I encourage the parents to just listen and don’t try and tell the child they’re wrong. Maybe it won’t turn out to be that your child is transgender or non-binary. Maybe they are going through a phase. But from my experience, by the time a child writes a text to say, ‘Hey, I want to tell you that I’m transgender or gender non-conforming,’ they’ve been thinking about this for awhile.”

Even if you don’t understand or don’t believe your child is transgender or non-binary, Weitzman says, continue to support them unconditionally and seek help through support groups, books, and other available resources.

Consideration #4: Words Matter—and they Stick

As with a first impression, you don’t get a second chance to have a first reaction. 

“Some parents will say, ‘What are you talking about? You never showed signs of being feminine or girlie. In fact, I’ve only seen you in baggy shorts and big t-shirts. Where is this coming from?’” Weitzman says.

“And they’ll come to me in tears saying, ‘How did this happen? Was it my fault? How come I didn’t see it?’ Many times they have said to me, ‘Please slow the process down.’”

This approach could backfire, she says. How does she know? She lived it.

“I think back to my own coming out experience,” she says. “All I can say is that it was devastating, extremely painful, and not affirming in any way. If fact, my mom said, ‘You will be an embarrassment to your family, you need to move out, and don’t tell anybody.’ This happened at the age of 22.” 

“This is why I do this work,” she continues. “Part of it is never wanting any child to go through what I went through. That’s why I say don’t panic and be loving no matter what. You can’t take hurtful words back and the remnants can last a lifetime.”

But that’s just the beginning, Weitzman explains. “It’s a process. It takes time. Sometimes I say to my young clients, ‘Listen, your parents are trying. They may be slipping up, but you just told them something you’ve known for awhile and they’re just finding out and are in shock. Try and be a little more patient with them.”

“And with the parents I’ll say, ‘I know this is really hard for you, but every time you misgender your child, you’re throwing a dagger into their heart.’ So try harder.”

Consideration #5: Little Things Mean a Lot

The most useful tool in the parental toolbox: their ears. “Listening and affirming,” Weitzman says. 

“When parents start using the correct pronouns (for example, they/them), it goes a long way,” she says. “They’ll say to me, ‘Well, it’s not grammatically correct’ and I will say to them, ‘I understand, but it’s what they prefer.’ They don’t see themselves as male or female. They see themselves as a third gender. When you start to address your child with their preferred pronouns, it shows them that you care and are trying.”

“And if you slip, don’t make a fuss. Just say, ‘Oh shoot, I’m sorry’ and move on.’” 

This is when the magic starts to happen, Weitzman says. “After a year or two, the closeness within families begins to blossom. Depending on the client, a young person may choose to start on puberty blockers or hormones which will help them feel more aligned with their body.” 

“Oftentimes the darkness lifts,” she says. “Kids and parents grow closer. At the end of the day, everyone deserves to be loved and accepted for whomever they are. Even if it takes a while, even when the journey is unpredictable, it’s well worth the effort.”